Quality Control Report - Duplicate Checklist

Contract No.

Contract Title.

• Date Of Inspection

  Date

Preparatory Phase

• Was Preparatory Phase Work Performed Today?

  Yes

  No

  N/A

• Definable Feature Of Work

Initial Phase

• Was Initial Phase Work Performed Today?

  Yes

  No

  N/A

• Definable Feature Of Work

Follow-up Phase

• Work Complies With Contract As Approved During Inital Phase

  Yes

  No

  N/A

• Work Complies With Safety Requirement

  Yes

  No

  N/A

• Description Of Work

• Definable Feature Of Work

Photos Of Job Site

• Photos Of Work done.

  Media

Rework Items Identified Today (Not Corrected By Close Of Business)

• Description

• Photos Of Rework Items Today.

  Media

• Site Supervisor

  Sign

Rework Items Corrected Today (From Rework Items List)

• Description

• Photos Of Rework Items Corrected Today.

  Media

Remarks (Also Explain Any Follow-up Phase Checklist Item From Above That Was Answered "NO"). Manuf. Rep On-Site, ect.

• Description

• Authorized QC Manager At Site

  Sign

Government Quality Assurance Report

• Description

• Government Quality Assurance Manager

  Sign